高灵敏度CRP水平对STEMI患者无回流现象的预测值
Xhevdet Krasniqi1,2, Josip Vincelj3, Dardan Koçinaj2
1Department of Internal Medicine, Medical Faculty, University of Prishtina "Hasan Prishtina", Prishtina, Kosovo.
Cardiology research and practice
|July 16, 2025
概括
高灵敏度C反应蛋白 (hs-CRP) 水平与接受初级皮肤穿冠状动脉干预 (pPCI) 的ST段升高心肌梗塞 (STEMI) 患者的no-reflow现象有关. 升高的hs-CRP可能表明再注射损伤的风险更高.
科学领域:
- 心脏病学 心脏病学
- 生物标志物 生物标志物
- 干预心脏病学 干预心脏病学
背景情况:
- 增加的高灵敏性C反应蛋白 (hs-CRP) 水平与无反流现象有关.
- 即使在ST段升高心肌梗塞 (STEMI) 中及时进行初级穿皮冠状动脉干预 (pPCI) 时,也可能发生反流损伤.
- 了解无回流的预测因素对于优化STEMI管理至关重要.
研究的目的:
- 评估hs-CRP水平对STEMI患者无回流现象发生率的影响.
- 为了确定潜在的hs-CRP截止值来预测无回流和再注射损伤风险.
主要方法:
- 包括182名症状发作小于12小时的STEMI患者的队列,这些患者接受了pPCI.
- 在入院时使用Cobas测定法测量hs-CRP水平.
- 患者被分为成功的再输血 (TIMI流量等级3) 和无再输血 (TIMI流量等级≤2) 两组.
主要成果:
- 没有回血的患者 (37.90 mg/L) 的hs-CRP水平的中位数明显高于成功再输血的患者 (8.5 mg/L) (p < 0.0001).
- 接收器操作特征 (ROC) 曲线分析显示曲线下的面积 (AUC) 为0.73 (95% CI,0.64-0.81).
- 18.0 mg/L的hs-CRP切割值被确定为无回流现象的预测指标 (p=0.0001).
结论:
- 升高的hs-CRP水平与pPCI治疗的STEMI患者的no-reflow现象显著相关.
- 18.0 mg/L的hs-CRP切割值可能有助于识别STEMI患者的反损伤风险增加.
- hs-CRP作为一种潜在的生物标志物,用于预测在STEMI中pPCI后的不良结果.
相关概念视频
01:30Acute Coronary Syndrome III: Diagnostic Studies
25
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
25
01:19Blood Studies for Cardiovascular System II: CRP, Hcy, and Cardiac Natriuretic Peptide Markers
218
Cardiac biomarkers are critical in diagnosing, prognosing, and managing cardiovascular diseases. Routine measurement of specific biomarkers such as B-type natriuretic peptide (BNP), C-reactive protein (CRP), and homocysteine (Hcy) is common practice in clinical settings to evaluate heart function and predict cardiovascular events.
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
These markers indicate stress or strain on the heart muscle:
Natriuretic Peptides (BNP)
Cardiac myocytes produce these hormones in response to ventricular stretching...
218
01:30Acute Coronary Syndrome I: Introduction
80
Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
80
01:20Blood Studies for Cardiovascular System I: Cardiac Biomarkers
342
Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
342
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
47
The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
47
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
123
Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
123